There are many instances in which it is surgically desirable or necessary to obtain access through a constrained bodily opening. For example, it may become desirable to access a patient's common bile duct to remove a gallstone or treat a biliary stricture. In order to access the common bile duct, an endoscopic retrograde cholangiopancreatography (ERCP) procedure may be performed, in which a physician inserts an endoscope into a patient's mouth, through the esophagus, stomach, and into the duodenum. The endoscope may comprise a working lumen through which a wire guide, catheter and/or other device may be loaded. Such devices may be guided, via the working lumen of the endoscope, into the duodenum, through the papilla of Vater, and then into the common bile duct.
There are several problems that may be encountered when advancing a wire guide or other device through the papilla of Vater and into the common bile duct. First, the insertion of the wire guide may be rendered difficult due to folds of soft tissue in the vicinity of the papillar opening, i.e., the folds of tissue may partially or fully block or impede access through the opening. Further, it may be difficult to achieve the proper angle necessary to gain entry from the duodenum into the common bile duct. If the proper angle is not achieved, an errant wire guide entry may cause damage to the relatively sensitive pancreatic duct.
One known technique for facilitating access into the common bile duct during an ERCP procedure is performing a sphincterectomy at the sphincter of Oddi. Several drawbacks are associated with sphincterectomies. For example, cutting the sphincter may lead to bleeding and acute pancreatitis. Further, an endoscopic sphincterectomy permanently destroys the sphincter of Oddi, thus exposing the biliary tree to the risk of future infection.
In view of the drawbacks of previously-known techniques, there is a need for a device that facilitates access into an anatomical opening while reducing the likelihood of damaging a patient's anatomy.